Title: Incidence of Peripheral Arterial Disease in Diabetic Foot Infection Patients: A Prospective Study
Authors: Dr V.K.Sharma, Dr Puneet Mahajan, Dr Rohit Dadhwal, Dr Anupam Jhobta
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.151
Abstract
A prospective study was conducted on 30 patients with Diabetes. Patients were evaluated on the basis of history, clinical examination, laboratory investigations, conventional radiological investigations and Arterial Doppler lower limb and Ankle Brachial Index assessment of the affected foot. The incidence and prevalence of peripheral vascular disease (PAD) increases with age in both diabetic and non-diabetic subjects and, in those with diabetes, increases with duration of diabetes1 Given the inconsistencies of clinical findings in the diagnosis of PAD in diabetic patient, measurement of ankle brachial pressure index (ABPI) has emerged as the relative simple, non-invasive and inexpensive diagnostic tool of choice. An ABPI < 0.9 is not only diagnostic of PAD even in asymptomatic patients, but is also an independent marker of increased morbidity and mortality from cardiovascular disease. In our study all thirty (100%) patients presented with ulcer. Twenty-two (73%) presented with single ulcer while eight (27%) patients presented with multiple ulcers. 86% patients had inadequate blood sugar control. 40% of patients presented with Grade II ulcers (according to Wagner’s Classification) followed by Grade III (37.5%) and Grade I (16%). Radiological examination of the foot showed changes in 17 (56%) patients. Commonest finding was osteomyelitis 7(23%) patients. 18(60%) patients were found to have peripheral arterial disease diagnosed on the basis of decreased ABPI (ankle brachial pressure index). One patient (3%) had ABPI abnormally high (value >1.4) due to calcification of wall and 11 (36%) had normal ABPI. Lower values of ABPI were observed with worsening of ulcer grade on Wagner Classification. We conclude that ABPI is very important non invasive adjunct for diagnosis of peripheral artery disease in diabetic patients.
Key words: ABPI- Ankle Brachial Pressure Index : PAD- Peripheral Arterial Disease
